Individual
AMANDA LEE KOSSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10930 CRABAPPLE RD, SUITE 140, ROSWELL, GA 30075-5813
(770) 641-8010
Mailing address
10930 CRABAPPLE RD, SUITE 140, ROSWELL, GA 30075-5813
(770) 641-8010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014645
GA
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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